There are differences between African-American and white patients with colorectal cancer, concerning their characteristics before and after diagnosis. Whites are more likely to adhere to screening guidelines. This is ...There are differences between African-American and white patients with colorectal cancer, concerning their characteristics before and after diagnosis. Whites are more likely to adhere to screening guidelines. This is also the case among people with positive family history. Colorectal cancer is more frequent in Blacks. Studies have shown that that since 1985, colon cancer rates have dipped 20% to 25% for Whites, while rates have gone up for African-American men and stayed the same for African-American women. Overall, African-Americans are 38% to 43% more likely to die from colon cancer than are Whites. Furthermore, it seems that there is an African-American predominance in right-sited tumors. African Americans tend to be diagnosed at a later stage, to suffer from better differentiated tumors, and to have worse prognosis when compared with Whites. Moreover, less black patients receive adjuvant chemotherapy for resectable colorectal cancer or radiation therapy for rectal cancer. Caucasians seem to respond better to standard chemotherapy regimens than AfricanAmericans. Concerning toxicity, it appears that patients of African-American descent are more likely to develop 5-FU toxicity than Whites, possibly because of their different dihydropyridine dehydrogenase status. Last but not least, screening surveillance seems to be higher among white than among black long-term colorectal cancer survivors. Socioeconomic and educational status account for most of these differences whereas little evidence exists for a genetic contribution in racial disparity. Understanding the nature of racial differences in colorectal cancer allows tailoring of screening and treatment interventions.展开更多
Dysregulated interactions between host inflammation and gut microbiota over the course of life increase the risk of colorectal cancer(CRC).While environmental factors and socio-economic realities of race remain predom...Dysregulated interactions between host inflammation and gut microbiota over the course of life increase the risk of colorectal cancer(CRC).While environmental factors and socio-economic realities of race remain predominant contributors to CRC disparities in African-Americans(AAs),this review focuses on the biological mediators of CRC disparity,namely the under-appreciated influence of inherited ancestral genetic regulation on mucosal innate immunity and its interaction with the microbiome.There remains a poor understanding of mechanisms linking immune-related genetic polymorphisms and microbiome diversity that could influence chronic inflammation and exacerbate CRC disparities in AAs.A better understanding of the relationship between host genetics,bacteria,and CRC pathogenesis will improve the prediction of cancer risk across race/ethnicity groups overall.展开更多
AIM: To compare adherence, response, and remission with light treatment in African-American and Caucasian patients with Seasonal Affective Disorder.METHODS: Seventy-eight study participants, agerange 18-64(51 African-...AIM: To compare adherence, response, and remission with light treatment in African-American and Caucasian patients with Seasonal Affective Disorder.METHODS: Seventy-eight study participants, agerange 18-64(51 African-Americans and 27 Caucasians)recruited from the Greater Baltimore Metropolitan area, with diagnoses of recurrent mood disorder with seasonal pattern, and confirmed by a Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-Ⅳ, were enrolled in an open label study of daily bright light treatment. The trial lasted6 wk with flexible dosing of light starting with 10000 lux bright light for 60 min daily in the morning. At the end of six weeks there were 65 completers. Three patients had Bipolar Ⅱ disorder and the remainder had Major depressive disorder. Outcome measures were remission(score ≤ 8) and response(50% reduction)in symptoms on the Structured Interview Guide for the Hamilton Rating Scale for Depression(SIGH-SAD)as well as symptomatic improvement on SIGH-SAD and Beck Depression Inventory-Ⅱ. Adherence was measured using participant daily log. Participant groups were compared using t-tests, chi square, linear and logistic regressions. RESULTS: The study did not find any significant group difference between African-Americans and their Caucasian counterparts in adherence with light treatment as well as in symptomatic improvement.While symptomatic improvement and rate of treatment response were not different between the two groups,African-Americans, after adjustment for age, gender and adherence, achieved a significantly lower remission rate(African-Americans 46.3%; Caucasians 75%; P =0.02).CONCLUSION: This is the first study of light treatment in African-Americans, continuing our previous work reporting a similar frequency but a lower awareness of SAD and its treatment in African-Americans. Similar rates of adherence, symptomatic improvement and treatment response suggest that light treatment is a feasible, acceptable, and beneficial treatment for SAD in African-American patients. These results should lead to intensifying education initiatives to increase awareness of SAD and its treatment in African-American communities to increased SAD treatment engagement.In African-American vs Caucasian SAD patients a remission gap was identified, as reported before with antidepressant medications for non-seasonal depression, demanding sustained efforts to investigate and then address its causes.展开更多
Reducing disparities in STI/HIV rates for young heterosexual African-American women in the US is a public health priority. Although several strategies can reduce risk, some sexually experienced young women are choosin...Reducing disparities in STI/HIV rates for young heterosexual African-American women in the US is a public health priority. Although several strategies can reduce risk, some sexually experienced young women are choosing to abstain from sex for various reasons and periods of time following sexual debut, a practice known as secondary abstinence. However, others who desire to practice secondary abstinence find it difficult to do so. This qualitative study explored barriers that explained the dissonance between interest in secondary abstinence and continued sexual activity. In-depth interviews were conducted with 20 sexually-experienced African-American adolescent females, ages 18 - 23, who expressed interest in secondary abstinence. Partner-related barriers that created power imbalances presented the greatest challenges to becoming or remaining abstinent. Findings suggest that teaching young women how to recognize characteristics of healthy and unhealthy relationships, identify power imbalances, communicate assertively and develop positive coping skills can empower young women to build healthier relationships with their partners.展开更多
Introduction: Although individual-level dietary behavior among racial/ethnic minority groups in the US is influenced by cultural food preferences and socioeconomic position, few studies of the food store environment h...Introduction: Although individual-level dietary behavior among racial/ethnic minority groups in the US is influenced by cultural food preferences and socioeconomic position, few studies of the food store environment have simultaneously examined both factors. The objective of this cross-sectional study was to investigate the availability of culturally specific fruits and vegetables for African Americans and Latinos by levels of neighborhood deprivation. The 5 small central Illinois cities selected for the study have exhibited increasing numbers of both racial/ ethnic groups in the last decade. Methods: A validated audit tool was used to survey 118 food stores in 2008. Census 2000 block group data was used to create a neighborhood deprivation index (categorized as low, medium, and high) based on socioeconomic characteristics using principal component analysis. Statistical analyses were performed in SPSS version 17.0 to determine whether the availability of culturally specific fruits and vegetables (n = 31) varied by neighborhood levels of deprivation and store type. Results: Fewer than 50% of neighborhoods carried culturally specific fruits and vegetables, with the lowest availability found in low deprivation neighborhoods (p < 0.05). Culturally specific fruits and vegetables were most often found in neighborhoods with medium levels of deprivation, and in grocery stores (p < 0.05). Latino fruits and vegetables were less likely to be found across neighborhoods or in stores, compared to African-American fruits and vegetables. Conclusions: The limited availability of culturally specific fruits and vegetables for African Americans and Latinos highlights potential environmental challenges with adherence to daily dietary guidelines for fruit and vegetable consumption in these groups.展开更多
Purpose: African-American men (AAM) have a greater risk of hypertension (HTN) than Caucasian men (CM). To reduce this risk, determining the differences in mechanisms involved in HTN and understanding the relationship ...Purpose: African-American men (AAM) have a greater risk of hypertension (HTN) than Caucasian men (CM). To reduce this risk, determining the differences in mechanisms involved in HTN and understanding the relationship between these mechanisms and factors affecting blood pressure (BP) in AAM and CM is necessary. One such mechanism is spontaneous baroreflex sensitivity (sBRS) and two factors are cardiorespiratory fitness (CRF) and arterial stiffness (AS). The aims of this study were to determine, firstly, whether there are differences in sBRS between young, normotensive AAM and CM, and secondly, to determine if CRF and AS are significant predictors of sBRS in young, normotensive AAM and CM. Methods: Twenty-three normotensive AAM and 36 CM were recruited from Southern Connecticut State University. Measures included anthropometric, sBRS (alpha-index), and CRF (maximal oxygen consumption [VO2max]), as well as AS (carotid-femoral pulse wave velocity [Cf-PWV]). Independent t-tests were used to determine differences between groups and multiple regression analysis was used to determine how much of the variation in sBRS was explained by CRF and AS. Results: The sBRS was significantly lower in AAM (10.3 ± 3.8 ms/mmHg) vs. CM (13.3 ± 5.7 ms/ mmHg), P = 0.03. CRF and AS were not significant predictors of sBRS in AAM (P = 0.25) and CM (P = 0.30). There was no relationship between, sBRS, CRF and AS;CRF was significantly reduced in AAM vs. CM (45.1 ± 6.3 vs. 52.1 ± 7.5 mL·kg?1·min?1, P ≤ 0.001). Conclusions: Young normotensive AAM demonstrated significantly lower sBRS vs. CM, irrespective of having fair CRF and normal BP. CRF and AS are not significant predictors of sBRS in young, normotensive AAM and CM. The attenuation in sBRS in AAM did not result in AAM having higher BP versus CM. This finding underscores the need for more detailed examination of the role of sBRS in the etiology of HTN in AAM.展开更多
Background: Sexually transmitted infections (STIs) such as chlamydia and gonorrhea are commonly reported infections in the United States. Greater Omaha has had continually higher reported rates of chlamydia and gonorr...Background: Sexually transmitted infections (STIs) such as chlamydia and gonorrhea are commonly reported infections in the United States. Greater Omaha has had continually higher reported rates of chlamydia and gonorrhea for more than a decade compared to the rest of the state rates. Minority and young adults have been disproportionately affected. Purpose: The objectives of our study were to estimate the prevalence and to identify risk factors for chlamydia and gonorrhea among young adults. Methods: We conducted a cross-sectional survey with 310 young adults aged 19 -25 years between June 2011 and June 2012. The study collected socio-demographic, behavioral and other risk factors for STIs utilizing a pre-design standardized questionnaire. Gonorrhea and chlamydia status of the participants were established by testing urine samples using PCR-based diagnostic technique. Descriptive and multivariable regression analyses were used to examine risk factors for STIs. Results: About 12.6% survey participants had at least one STI test positive. Lower education was associated with STIs but was not statistically significant (Odd Ratio for no schooling was 8.24, 95% CI 0.93 -72.86, Odd Ratio for high school education was 2.05, 95% CI 0.25 -16.63 compared to associate or college level education). No other predictors were associated with STIs. The average age of the first sexual intercourse was lower, and the number of sexual partners was higher compared to their national counterparts. Conclusion: We found a higher percentage of STI-positive individuals compared to previously reported county-level estimates. Education was the single and most important predictor of positive STI status.展开更多
The objective of this study was to develop an educational program for African-American females on diet and exercise in the treatment and prevention of obesity. African-American female participants aged 30-50 with a Bo...The objective of this study was to develop an educational program for African-American females on diet and exercise in the treatment and prevention of obesity. African-American female participants aged 30-50 with a Body Mass Index (BMI) over 25 were recruited for inclusion in the study. A qualitative assessment was completed which observed the attitudes, personal beliefs, dietary and physical risk factors regarding weight loss before and after an educational intervention which focused specifically on the targeted population. Pre- and post-assessment questionnaires were utilized in this study. This design intended to measure whether the educational intervention affected real change among the participant’s lifestyle choices. Results revealed that most participants initially did not consider themselves to be overweight or obese and that after the education intervention, realized that they were overweight or obese. Many participants felt that their support systems were adequate. Initially, participants consumed fried foods and high calorie drinks. After the educational intervention, many preferred baked foods and decreased the intake of high calorie drinks. Emotions were also identified as a cause of overeating. Many participants found the educational sessions beneficial to their weight loss and fitness efforts. Challenges such as lack of adequate social support and emotions controlling eating patterns still exist in this population and need to be addressed. The creation of standardized protocols to directly address emotional needs at every medical visit would assist in identification of problems which could negatively affect lifestyle choices.展开更多
Toni Morrison,the winner of the Nobel Prize for Literature in 1993,has been hailed as one of the greatest American authors of the 20th century.Her works explore and portray blacks’destiny,history,and spiritual world,...Toni Morrison,the winner of the Nobel Prize for Literature in 1993,has been hailed as one of the greatest American authors of the 20th century.Her works explore and portray blacks’destiny,history,and spiritual world,emphasizing on gender,race,and culture.Song of Solomon and Beloved,the two novels the thesis has selected to make analysis are crucial to her writing career.Toni Morrison’s great many literary works anatomize the survival and psychological pain of African Americans under the restrain and repression of mainstream culture,trying to find out a solution.展开更多
Background: Rapid steroid withdrawal (RSW) is used increasingly in kidney transplantation but long-term outcomes in African-American (AA) recipients are not well known. We compared 1 and 5 year transplant outcomes in ...Background: Rapid steroid withdrawal (RSW) is used increasingly in kidney transplantation but long-term outcomes in African-American (AA) recipients are not well known. We compared 1 and 5 year transplant outcomes in a large cohort of AA patients who were maintained on continued steroid therapy (CST) to those who underwent RSW. Methods: Post-transplant courses of A as receiving kidney allografts from 2003-2011 at two urban transplant centers in Chicago were followed. Prior to outcome analysis, we used Inverse Probability of Treatment Weights (IPTW) to match the two groups on a set of baseline risk factors. Graft and patient survival, GFR at 1 and 5 years, incidence and type of rejection, incidence of post-transplant diabetes mellitus (PTDM), delayed graft function, CMV and BK viremia were compared. Results: There were 150 AA recipients in the CST analytic group and 157 in the RSW analytic group. Graft and patient survival was similar between the two groups. Rates of CMV viremia were higher in the RSW compared to the CST analytic group at 1 year. Biopsy-proven acute rejection and PTDM were similar between the RSW and CST groups. Conclusions: In AA recipients, RSW has similar long-term outcomes to CST.展开更多
Alice Walker's famous short story Everyday Use reveals African American's awareness of cultural heritage, which is deeply affected by the"double consciousness"as well as their racial identification i...Alice Walker's famous short story Everyday Use reveals African American's awareness of cultural heritage, which is deeply affected by the"double consciousness"as well as their racial identification in the Civil Rights Movement. Through the exploration of the cultural conflict reflected in Everyday Use by relating to the influence on black people produced by the AfricanAmerican Civil Rights Movement, and the discussion of the different attitudes of the mother and her daughters towards their cultural heritage, the essay aims to reinforce Alice Walker's claim that any attempt to lay too much emphasis on the ideas of utilitarian return to black people's traditional culture is shallow and superficial.展开更多
Objective: The aim of the study was to investigate in postmenopausal women whether the relationship between percentage body fat (PBF) and body mass index (BMI) differs between Asians living in Beijing (BA) and African...Objective: The aim of the study was to investigate in postmenopausal women whether the relationship between percentage body fat (PBF) and body mass index (BMI) differs between Asians living in Beijing (BA) and African-Americans (AA), and Caucasians (Ca) living in New York City. Methods: Healthy postmenopausal women (231 BA; 113 AA, 95 Ca), aged 50-80 years, were studied. Weight, height and PBF by dual energy X-ray absorptiometry (DXA) were measured. The relationship between PBF and BMI was assessed by multiple regression analysis. Results: Race, reciprocal of BMI (1/BMI) and the interaction between race and 1/BMI were all significantly (P<0.05) related to PBF in this sample. The slope of the line relating 1/BMI to PBF was different for BA compared to AA (P=0.01) and Ca (P=0.003) while the slopes for AA and Ca were not different (P>0.05). At lower levels of BMI, Asians tended to have higher PBF comparable to AA and Ca, while at BMI >30 BA tended to have less PBF than the other groups. Conclusion: The relation between PBF and BMI in BA postmenopausal women differs from that of AA and Ca women in this sample.展开更多
A common strategy for improving health behaviors is to emphasize the benefits and reduce the barriers to behavior change. This study investigated potential differences in perceived benefits and barriers related to par...A common strategy for improving health behaviors is to emphasize the benefits and reduce the barriers to behavior change. This study investigated potential differences in perceived benefits and barriers related to participation in physical activity (PA) between women in pre-maintenance versus the maintenance phase of PA behavior to determine if perceived benefits were greater and perceived barriers lower in women with more extensive and successful PA participation experience. Data were collected from a community-based sample (N = 113) of middle-aged African-American women. The sample was stratified into two groups according to how long they had been regularly engaging in PA (6 months or longer versus less than 6 months). Chi-square analyses were conducted to investigate possible differences between the two groups of women in regard to perceived benefits and barriers associated with PA. Descriptive data showed that nearly all of the benefits and barriers to PA were perceived as being important for a majority of the participants and chi-square and t-test results indicated few significant between-group differences (p < .05) in regard to these perceptions. Additional analyses indicated there was no significant between-group difference (p < .05) for Body Mass Index. The results suggest the benefits and barriers related to PA behavior are already valued and understood by many African-American women. Further, the results do not support the commonly held belief that effective health behavior improvement programming should emphasize the benefits and reduce the barriers related to the behavior. Practitioners should consider focusing on other evidenced based factors proven to promote PA behavior such as counseling regarding social support (e.g., buddy system) and increasing self-efficacy (e.g., goal setting) to initiate and sustain a physically active lifestyle.展开更多
Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, ...Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results: Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions: This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.展开更多
Objective: To determine the feasibility of a behavioral faith-based PREMIER study modified hypertension (HTN) control intervention in a semi urban African-American (AA) church. Methods: In a prospective longitudinal s...Objective: To determine the feasibility of a behavioral faith-based PREMIER study modified hypertension (HTN) control intervention in a semi urban African-American (AA) church. Methods: In a prospective longitudinal study design, a 12-week behavioral HEALS (Healthy Eating and Living Spiritually) intervention was tested for its feasibility and efficacy in a semi urban AA church. High-risk adult church members with HTN were recruited. Program sessions were weekly delivered by the trained church members. Data were analyzed using repeated measures ANOVA. Results: 22 of 34 subjects (65% retention) provided complete information on the outcome measures. Mean systolic blood pressure (SBP) reduction from baseline was 22 mmHg (p < 0.001) and 6.5 mmHg for diastolic BP (p = 0.0048). Mean weight reduction of 3.11 kg from the baseline (p < 0.0001) was also observed. 91% subjects attended 7 - 9 sessions. Conclusion: Promoting behavioral HTN control interventions in high risk AAs by empowering AA church communities is feasible and efficacious.展开更多
This work provides a descriptive analysis of the so-called Black American community whose practical consciousness is a result of adopting,and reacting to,both white values and discriminatory terms to constitute their ...This work provides a descriptive analysis of the so-called Black American community whose practical consciousness is a result of adopting,and reacting to,both white values and discriminatory terms to constitute their practical activities and so-called cultural identity.Outside of the practices associated with these values and discriminatory terms,there is no sui generis Black American identity and community with its own form of system and social integration that is different from,or diametrically opposes,the Protestant Ethic and the spirit of capitalism of their white counterparts,which would emerge out of that relationship.展开更多
文摘There are differences between African-American and white patients with colorectal cancer, concerning their characteristics before and after diagnosis. Whites are more likely to adhere to screening guidelines. This is also the case among people with positive family history. Colorectal cancer is more frequent in Blacks. Studies have shown that that since 1985, colon cancer rates have dipped 20% to 25% for Whites, while rates have gone up for African-American men and stayed the same for African-American women. Overall, African-Americans are 38% to 43% more likely to die from colon cancer than are Whites. Furthermore, it seems that there is an African-American predominance in right-sited tumors. African Americans tend to be diagnosed at a later stage, to suffer from better differentiated tumors, and to have worse prognosis when compared with Whites. Moreover, less black patients receive adjuvant chemotherapy for resectable colorectal cancer or radiation therapy for rectal cancer. Caucasians seem to respond better to standard chemotherapy regimens than AfricanAmericans. Concerning toxicity, it appears that patients of African-American descent are more likely to develop 5-FU toxicity than Whites, possibly because of their different dihydropyridine dehydrogenase status. Last but not least, screening surveillance seems to be higher among white than among black long-term colorectal cancer survivors. Socioeconomic and educational status account for most of these differences whereas little evidence exists for a genetic contribution in racial disparity. Understanding the nature of racial differences in colorectal cancer allows tailoring of screening and treatment interventions.
文摘Dysregulated interactions between host inflammation and gut microbiota over the course of life increase the risk of colorectal cancer(CRC).While environmental factors and socio-economic realities of race remain predominant contributors to CRC disparities in African-Americans(AAs),this review focuses on the biological mediators of CRC disparity,namely the under-appreciated influence of inherited ancestral genetic regulation on mucosal innate immunity and its interaction with the microbiome.There remains a poor understanding of mechanisms linking immune-related genetic polymorphisms and microbiome diversity that could influence chronic inflammation and exacerbate CRC disparities in AAs.A better understanding of the relationship between host genetics,bacteria,and CRC pathogenesis will improve the prediction of cancer risk across race/ethnicity groups overall.
基金Supported by The National Institute of Mental Health of the National Institutes of Health under award No.1R34MH073797-01A2(PI Postolache TT)in part by the National Institutes of Health award No.K12RR023250-01(PI Reeves GM)by the National Center for Research Resources of the National Institutes of Health award No.M01 RR 16500(General Clinical Research Program)
文摘AIM: To compare adherence, response, and remission with light treatment in African-American and Caucasian patients with Seasonal Affective Disorder.METHODS: Seventy-eight study participants, agerange 18-64(51 African-Americans and 27 Caucasians)recruited from the Greater Baltimore Metropolitan area, with diagnoses of recurrent mood disorder with seasonal pattern, and confirmed by a Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-Ⅳ, were enrolled in an open label study of daily bright light treatment. The trial lasted6 wk with flexible dosing of light starting with 10000 lux bright light for 60 min daily in the morning. At the end of six weeks there were 65 completers. Three patients had Bipolar Ⅱ disorder and the remainder had Major depressive disorder. Outcome measures were remission(score ≤ 8) and response(50% reduction)in symptoms on the Structured Interview Guide for the Hamilton Rating Scale for Depression(SIGH-SAD)as well as symptomatic improvement on SIGH-SAD and Beck Depression Inventory-Ⅱ. Adherence was measured using participant daily log. Participant groups were compared using t-tests, chi square, linear and logistic regressions. RESULTS: The study did not find any significant group difference between African-Americans and their Caucasian counterparts in adherence with light treatment as well as in symptomatic improvement.While symptomatic improvement and rate of treatment response were not different between the two groups,African-Americans, after adjustment for age, gender and adherence, achieved a significantly lower remission rate(African-Americans 46.3%; Caucasians 75%; P =0.02).CONCLUSION: This is the first study of light treatment in African-Americans, continuing our previous work reporting a similar frequency but a lower awareness of SAD and its treatment in African-Americans. Similar rates of adherence, symptomatic improvement and treatment response suggest that light treatment is a feasible, acceptable, and beneficial treatment for SAD in African-American patients. These results should lead to intensifying education initiatives to increase awareness of SAD and its treatment in African-American communities to increased SAD treatment engagement.In African-American vs Caucasian SAD patients a remission gap was identified, as reported before with antidepressant medications for non-seasonal depression, demanding sustained efforts to investigate and then address its causes.
文摘Reducing disparities in STI/HIV rates for young heterosexual African-American women in the US is a public health priority. Although several strategies can reduce risk, some sexually experienced young women are choosing to abstain from sex for various reasons and periods of time following sexual debut, a practice known as secondary abstinence. However, others who desire to practice secondary abstinence find it difficult to do so. This qualitative study explored barriers that explained the dissonance between interest in secondary abstinence and continued sexual activity. In-depth interviews were conducted with 20 sexually-experienced African-American adolescent females, ages 18 - 23, who expressed interest in secondary abstinence. Partner-related barriers that created power imbalances presented the greatest challenges to becoming or remaining abstinent. Findings suggest that teaching young women how to recognize characteristics of healthy and unhealthy relationships, identify power imbalances, communicate assertively and develop positive coping skills can empower young women to build healthier relationships with their partners.
文摘Introduction: Although individual-level dietary behavior among racial/ethnic minority groups in the US is influenced by cultural food preferences and socioeconomic position, few studies of the food store environment have simultaneously examined both factors. The objective of this cross-sectional study was to investigate the availability of culturally specific fruits and vegetables for African Americans and Latinos by levels of neighborhood deprivation. The 5 small central Illinois cities selected for the study have exhibited increasing numbers of both racial/ ethnic groups in the last decade. Methods: A validated audit tool was used to survey 118 food stores in 2008. Census 2000 block group data was used to create a neighborhood deprivation index (categorized as low, medium, and high) based on socioeconomic characteristics using principal component analysis. Statistical analyses were performed in SPSS version 17.0 to determine whether the availability of culturally specific fruits and vegetables (n = 31) varied by neighborhood levels of deprivation and store type. Results: Fewer than 50% of neighborhoods carried culturally specific fruits and vegetables, with the lowest availability found in low deprivation neighborhoods (p < 0.05). Culturally specific fruits and vegetables were most often found in neighborhoods with medium levels of deprivation, and in grocery stores (p < 0.05). Latino fruits and vegetables were less likely to be found across neighborhoods or in stores, compared to African-American fruits and vegetables. Conclusions: The limited availability of culturally specific fruits and vegetables for African Americans and Latinos highlights potential environmental challenges with adherence to daily dietary guidelines for fruit and vegetable consumption in these groups.
文摘Purpose: African-American men (AAM) have a greater risk of hypertension (HTN) than Caucasian men (CM). To reduce this risk, determining the differences in mechanisms involved in HTN and understanding the relationship between these mechanisms and factors affecting blood pressure (BP) in AAM and CM is necessary. One such mechanism is spontaneous baroreflex sensitivity (sBRS) and two factors are cardiorespiratory fitness (CRF) and arterial stiffness (AS). The aims of this study were to determine, firstly, whether there are differences in sBRS between young, normotensive AAM and CM, and secondly, to determine if CRF and AS are significant predictors of sBRS in young, normotensive AAM and CM. Methods: Twenty-three normotensive AAM and 36 CM were recruited from Southern Connecticut State University. Measures included anthropometric, sBRS (alpha-index), and CRF (maximal oxygen consumption [VO2max]), as well as AS (carotid-femoral pulse wave velocity [Cf-PWV]). Independent t-tests were used to determine differences between groups and multiple regression analysis was used to determine how much of the variation in sBRS was explained by CRF and AS. Results: The sBRS was significantly lower in AAM (10.3 ± 3.8 ms/mmHg) vs. CM (13.3 ± 5.7 ms/ mmHg), P = 0.03. CRF and AS were not significant predictors of sBRS in AAM (P = 0.25) and CM (P = 0.30). There was no relationship between, sBRS, CRF and AS;CRF was significantly reduced in AAM vs. CM (45.1 ± 6.3 vs. 52.1 ± 7.5 mL·kg?1·min?1, P ≤ 0.001). Conclusions: Young normotensive AAM demonstrated significantly lower sBRS vs. CM, irrespective of having fair CRF and normal BP. CRF and AS are not significant predictors of sBRS in young, normotensive AAM and CM. The attenuation in sBRS in AAM did not result in AAM having higher BP versus CM. This finding underscores the need for more detailed examination of the role of sBRS in the etiology of HTN in AAM.
文摘Background: Sexually transmitted infections (STIs) such as chlamydia and gonorrhea are commonly reported infections in the United States. Greater Omaha has had continually higher reported rates of chlamydia and gonorrhea for more than a decade compared to the rest of the state rates. Minority and young adults have been disproportionately affected. Purpose: The objectives of our study were to estimate the prevalence and to identify risk factors for chlamydia and gonorrhea among young adults. Methods: We conducted a cross-sectional survey with 310 young adults aged 19 -25 years between June 2011 and June 2012. The study collected socio-demographic, behavioral and other risk factors for STIs utilizing a pre-design standardized questionnaire. Gonorrhea and chlamydia status of the participants were established by testing urine samples using PCR-based diagnostic technique. Descriptive and multivariable regression analyses were used to examine risk factors for STIs. Results: About 12.6% survey participants had at least one STI test positive. Lower education was associated with STIs but was not statistically significant (Odd Ratio for no schooling was 8.24, 95% CI 0.93 -72.86, Odd Ratio for high school education was 2.05, 95% CI 0.25 -16.63 compared to associate or college level education). No other predictors were associated with STIs. The average age of the first sexual intercourse was lower, and the number of sexual partners was higher compared to their national counterparts. Conclusion: We found a higher percentage of STI-positive individuals compared to previously reported county-level estimates. Education was the single and most important predictor of positive STI status.
文摘The objective of this study was to develop an educational program for African-American females on diet and exercise in the treatment and prevention of obesity. African-American female participants aged 30-50 with a Body Mass Index (BMI) over 25 were recruited for inclusion in the study. A qualitative assessment was completed which observed the attitudes, personal beliefs, dietary and physical risk factors regarding weight loss before and after an educational intervention which focused specifically on the targeted population. Pre- and post-assessment questionnaires were utilized in this study. This design intended to measure whether the educational intervention affected real change among the participant’s lifestyle choices. Results revealed that most participants initially did not consider themselves to be overweight or obese and that after the education intervention, realized that they were overweight or obese. Many participants felt that their support systems were adequate. Initially, participants consumed fried foods and high calorie drinks. After the educational intervention, many preferred baked foods and decreased the intake of high calorie drinks. Emotions were also identified as a cause of overeating. Many participants found the educational sessions beneficial to their weight loss and fitness efforts. Challenges such as lack of adequate social support and emotions controlling eating patterns still exist in this population and need to be addressed. The creation of standardized protocols to directly address emotional needs at every medical visit would assist in identification of problems which could negatively affect lifestyle choices.
文摘Toni Morrison,the winner of the Nobel Prize for Literature in 1993,has been hailed as one of the greatest American authors of the 20th century.Her works explore and portray blacks’destiny,history,and spiritual world,emphasizing on gender,race,and culture.Song of Solomon and Beloved,the two novels the thesis has selected to make analysis are crucial to her writing career.Toni Morrison’s great many literary works anatomize the survival and psychological pain of African Americans under the restrain and repression of mainstream culture,trying to find out a solution.
文摘Background: Rapid steroid withdrawal (RSW) is used increasingly in kidney transplantation but long-term outcomes in African-American (AA) recipients are not well known. We compared 1 and 5 year transplant outcomes in a large cohort of AA patients who were maintained on continued steroid therapy (CST) to those who underwent RSW. Methods: Post-transplant courses of A as receiving kidney allografts from 2003-2011 at two urban transplant centers in Chicago were followed. Prior to outcome analysis, we used Inverse Probability of Treatment Weights (IPTW) to match the two groups on a set of baseline risk factors. Graft and patient survival, GFR at 1 and 5 years, incidence and type of rejection, incidence of post-transplant diabetes mellitus (PTDM), delayed graft function, CMV and BK viremia were compared. Results: There were 150 AA recipients in the CST analytic group and 157 in the RSW analytic group. Graft and patient survival was similar between the two groups. Rates of CMV viremia were higher in the RSW compared to the CST analytic group at 1 year. Biopsy-proven acute rejection and PTDM were similar between the RSW and CST groups. Conclusions: In AA recipients, RSW has similar long-term outcomes to CST.
文摘Alice Walker's famous short story Everyday Use reveals African American's awareness of cultural heritage, which is deeply affected by the"double consciousness"as well as their racial identification in the Civil Rights Movement. Through the exploration of the cultural conflict reflected in Everyday Use by relating to the influence on black people produced by the AfricanAmerican Civil Rights Movement, and the discussion of the different attitudes of the mother and her daughters towards their cultural heritage, the essay aims to reinforce Alice Walker's claim that any attempt to lay too much emphasis on the ideas of utilitarian return to black people's traditional culture is shallow and superficial.
文摘Objective: The aim of the study was to investigate in postmenopausal women whether the relationship between percentage body fat (PBF) and body mass index (BMI) differs between Asians living in Beijing (BA) and African-Americans (AA), and Caucasians (Ca) living in New York City. Methods: Healthy postmenopausal women (231 BA; 113 AA, 95 Ca), aged 50-80 years, were studied. Weight, height and PBF by dual energy X-ray absorptiometry (DXA) were measured. The relationship between PBF and BMI was assessed by multiple regression analysis. Results: Race, reciprocal of BMI (1/BMI) and the interaction between race and 1/BMI were all significantly (P<0.05) related to PBF in this sample. The slope of the line relating 1/BMI to PBF was different for BA compared to AA (P=0.01) and Ca (P=0.003) while the slopes for AA and Ca were not different (P>0.05). At lower levels of BMI, Asians tended to have higher PBF comparable to AA and Ca, while at BMI >30 BA tended to have less PBF than the other groups. Conclusion: The relation between PBF and BMI in BA postmenopausal women differs from that of AA and Ca women in this sample.
文摘A common strategy for improving health behaviors is to emphasize the benefits and reduce the barriers to behavior change. This study investigated potential differences in perceived benefits and barriers related to participation in physical activity (PA) between women in pre-maintenance versus the maintenance phase of PA behavior to determine if perceived benefits were greater and perceived barriers lower in women with more extensive and successful PA participation experience. Data were collected from a community-based sample (N = 113) of middle-aged African-American women. The sample was stratified into two groups according to how long they had been regularly engaging in PA (6 months or longer versus less than 6 months). Chi-square analyses were conducted to investigate possible differences between the two groups of women in regard to perceived benefits and barriers associated with PA. Descriptive data showed that nearly all of the benefits and barriers to PA were perceived as being important for a majority of the participants and chi-square and t-test results indicated few significant between-group differences (p < .05) in regard to these perceptions. Additional analyses indicated there was no significant between-group difference (p < .05) for Body Mass Index. The results suggest the benefits and barriers related to PA behavior are already valued and understood by many African-American women. Further, the results do not support the commonly held belief that effective health behavior improvement programming should emphasize the benefits and reduce the barriers related to the behavior. Practitioners should consider focusing on other evidenced based factors proven to promote PA behavior such as counseling regarding social support (e.g., buddy system) and increasing self-efficacy (e.g., goal setting) to initiate and sustain a physically active lifestyle.
文摘Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results: Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions: This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.
文摘Objective: To determine the feasibility of a behavioral faith-based PREMIER study modified hypertension (HTN) control intervention in a semi urban African-American (AA) church. Methods: In a prospective longitudinal study design, a 12-week behavioral HEALS (Healthy Eating and Living Spiritually) intervention was tested for its feasibility and efficacy in a semi urban AA church. High-risk adult church members with HTN were recruited. Program sessions were weekly delivered by the trained church members. Data were analyzed using repeated measures ANOVA. Results: 22 of 34 subjects (65% retention) provided complete information on the outcome measures. Mean systolic blood pressure (SBP) reduction from baseline was 22 mmHg (p < 0.001) and 6.5 mmHg for diastolic BP (p = 0.0048). Mean weight reduction of 3.11 kg from the baseline (p < 0.0001) was also observed. 91% subjects attended 7 - 9 sessions. Conclusion: Promoting behavioral HTN control interventions in high risk AAs by empowering AA church communities is feasible and efficacious.
文摘This work provides a descriptive analysis of the so-called Black American community whose practical consciousness is a result of adopting,and reacting to,both white values and discriminatory terms to constitute their practical activities and so-called cultural identity.Outside of the practices associated with these values and discriminatory terms,there is no sui generis Black American identity and community with its own form of system and social integration that is different from,or diametrically opposes,the Protestant Ethic and the spirit of capitalism of their white counterparts,which would emerge out of that relationship.
